Licensing Examination

Part III – Clinical Examination

This part of the examination is designed to test candidates’ ability to apply professional knowledge to clinical problems in Medicine, Surgery (including Orthopaedic Surgery), Obstetrics & Gynaecology and Paediatrics. Candidates must have passed Part I and Part II before applying to take Part III.

The Clinical Examinations are held in different hospitals in Hong Kong. Therefore, there may be some variations in the setting of examination venues. Candidates can answer in English, Cantonese or Putonghua (choice to be made in the application form).

General Procedures
The generic procedures and logistics are illustrated in the video below.

The following videos demonstrate the processes of clinical examinations in Medicine, Surgery, Paediatrics and Obstetrics & Gynaecology.

Some of the examinations are held in Objective Structured Clinical Examination (OSCE) format and some are long- and short-case examinations.

Candidates must follow the infection control measures implemented at the examination centre. Candidates who fail to comply with any of the infection control measures will be regarded as having breached the examination rules and may not be allowed for entering the examination centre or be disqualified from the examination.

The candidate will be tested in a long case for 20 minutes and several short cases for 40 minutes. Real patients will be involved.

To prepare for the long case, the candidate will be given 40 minutes for history taking and physical examination, followed by 20 minutes for questioning by two examiners. He should check for the physical signs of the patients. The candidate will be tested on the clinical management of the patients.

For the short cases, the candidate will be examined by two pairs of examiners at 2 stations, each for 20 minutes. At Station 1, the candidate will be tested in cases of Abdomen (for 8 minutes), Cardiovascular System (for 8 minutes) and General Medicine (such as Joint, Thyroid, Fundi, etc.) (for 4 minutes). At Station 2, the candidate will be tested in cases of Respiratory System (for 8 minutes), Neurology (for 8 minutes) and General Medicine (for 4 minutes). Written tasks can be part of a station in short-case examinations.

Candidates will be tested on a selection of cases and investigations in Objective Structured Clinical Examination (OSCE). There will be 8 OSCE stations (5 interactive stations and 3 non-interactive stations) with one examiner and 6 minutes duration for each station. The aim of the examination is to ensure that the candidate is competent to handle clinical situations, including history taking, physical examination, interpretation of investigations and treatment. The stations may be either interactive or non-interactive. At least one station will be devoted to an Orthopaedic problem. Real patients will be involved in interactive stations. Candidates may need to complete written tasks in non-interactive stations. Rest stations may also be present in addition to these 8 OSCE stations.

Some of the examples of themes in OSCE stations are as follows: history taking and communication, investigation and management, procedural skills, X-ray in Orthopaedic Surgery and clinical stations in head & neck, breast, vascular system, abdomen, hernia, lumps & bumps and Orthopaedic Surgery.

Each candidate will be tested in a long case and four short cases.

In the long case examination, he will be given 20 minutes to clerk case with a surrogate in the presence of two examiners, followed by a 10-minute discussion with the two examiners. The aim is to test the candidate’s communication skills, competence in interpreting symptoms and identifying the key problems, and ability to arrive at a diagnosis and suggest relevant investigations and management measures.

In regard to the short cases, each candidate will be examined by four pairs of examiners for four virtual / simulated cases. These cases will cover cardiovascular system, neurological system, respiratory system, and general examination. Each case will last for 10 minutes. The aim is to test the candidate’s competency in identifying and interpreting physical signs. No real patients will be involved. Video clips, laboratory findings, and other clinical materials will be used.

This is an Objective Structured Clinical Examination (OSCE).
There will be 10 stations (3 interactive stations and 7 non-interactive stations) with one examiner for each interactive station. Each candidate will start with a specific station and then rotate through all the stations.
There may be station(s) to examine the candidates' clinical skills. There may be resting station(s) depending on the number of candidates. No real patients will be involved.
Each station lasts for 9 minutes. A bell will ring to signify the start of the examination. At the end of the 9 minutes, a bell will ring again to signify the end of the station and all candidates must move out of the station. There will be a one-minute break between each station.
Candidates are not allowed to write in the answer sheets during any resting stations or the break between stations.
Non-interactive stations :
  - Each station will have one or more probe objects, based on which students are required to answer questions. The probe objects could be anything related to the specialty, such as a chart, an instrument, a photograph, a pathology specimen, a short description of a patient, etc.
  - Candidates are required to write their answers only in the answer sheets provided.
  - Where appropriate, answers may be given in note form or phrases or lists.
  - Candidates are not allowed to remove, alter, or write on the probes. Any attempt to change the probe in any form is not allowed.
Interactive stations :
  - Question sheets may be given to the candidate. The candidate is allowed to read the question during the one-minute break between stations but is not allowed to answer before the starting bell rings.

  1. Examiners will normally speak in English throughout the examination. Some examiners may choose to speak in Cantonese or Putonghua to facilitate communication if they are proficient in that language.

  2. Candidates may choose English, Cantonese, or Putonghua as the spoken language used in the examination. Interpreters will be arranged if the language used by the candidate is different from that of the patients and if the candidate has so indicated in the application form.

  3. The written signages and instructions in the clinical examination, being simple English, will be provided in English only.

Allocation of Seats in Part III Clinical Examination
Part III (Clinical Examination) has a capacity for 72 candidates only. If the number of applicants exceeds 72, the seats will be allocated in accordance with the mechanism set out in Appendix II of the Guidance Notes to Applicants.

Before the Clinical Examination

Candidates should arrive at the examination venue 20 minutes before the commencement of the examination for reporting to the invigilators. Candidates who are late may NOT be allowed to take the examination, save for very exceptional circumstances.
Candidates must bring to the examination venue their Hong Kong Identity Card or passport (i.e., the SAME identity document registered in the application form) and the letter of invitation. Candidates who fail to provide any such proof of identity may not be allowed to take the examination.
Candidates are required to dress decently for the examination. No T-shirts, jeans or training shoes are to be worn. The chief examiners and invigilators may refuse to admit candidates who do not follow this instruction.
White coats are optional.
Only stethoscopes and pens are allowed in the examination venue. Candidates are not allowed to bring any books, paper or other instruments (e.g. measuring tapes) into the examination venue. All such materials, if required, will be provided by the examination venue.
Candidates are also not allowed to bring pagers, mobile phones or other communication devices to the examination venue. These items will be temporarily kept by the invigilators and returned to the candidates after the examination. Candidates are advised not to bring any valuables to the examination venue. Due to the limitations of the examination venue, candidates should only bring the necessary items to the examination venue.
Candidates are advised to bring a watch that will not emit sound, store data or transmit information to the examination venue.

During the Clinical Examination

Make sure that the beeping function of your alarm watch, if any, has been turned off.
Listen to the instructions of examiners carefully.
Candidates may be required to take a patient history during the examination. Please write legibly so that the examiners can read the handwriting if necessary.
Always show respect to patients and examiners.
The examiners may ask candidates questions at any time during the examination. Never answer questions with a wild guess.

After the Clinical Examination

Candidates may be required to stay in a quarantine room after the examination until all other candidates have finished the examination. Please follow the instructions of the staff on duty.

Important Note

Candidates should note that their performance at each of the different parts or stations of the examination will be considered independently. A good pass in one part of the examination cannot compensate a failure in the other part of the same examination. The final grade of the examination will be decided at the meeting of the examiners after the examination.